Rehab Scheduler Representative

Overview

Shift: Day

Job Summary: Under the direction of the Rehabilitation Services Office Supervisor and the Director of Rehabilitation Services, the Scheduling Representative is responsible for general reception and administrative functions as well as, accurately collecting, analyzing and recording the required demographic, insurance/financial and clinical data necessary to schedule, preregister and register all types of patients to ensure that bills are produced according to regulatory and payer requirements;

effectively completes all activities including medical necessity and managed care requirement screening, and third party eligibility. Verifying benefits to ensure maximum payer compliance is maintained and maximum reimbursement is secured for Physical, Occupational and Speech Therapy. Interacts in a customer-focused manner at points during the access and later activities as appropriate, to ensure that patient’s and their representatives’ needs are met and that they understand and comply with expectations including resolving their personal liabilities through various payment and program options.

Demonstrates Competency in the Following General Areas:

• Commits to one hundred percent (100%) patient and customer satisfaction by always exhibiting a courteous and helpful manner during interactions with others, including patients, families, visitors, physicians and co-workers.
• Maintains a general, overall working knowledge of the department’s policies and procedures, thereby having the ability to provide basic service and support to others, including patients, families, visitors, physicians and co-workers. Recognizes when others are in need of assistance and consistently offers to help when own workload permits.
• Fully knowledgeable of the comprehensive revenue cycle policies, procedural flow, and standards and able to apply this knowledge to all situations.

Demonstrates Competency in the Following Primary Duties:

• Ability to understand and explain appropriate information to patients and other parties regarding scheduled appointments, financial liability, Advance Beneficiary Notification, and other attestations as applicable.
• Accurately collects and analyzes all required patient information, insurance/financial and clinical data elements necessary to schedule/register all types of patients by interviewing physicians and their office personnel, other referring providers, the patient and/or appropriate patient representative(s); receiving information via facsimile transmission, mail, previously recorded information, and all other available documents and forms such as insurance cards, etc.; and records and electronically enters the information on a timely basis.
• Knowledge of Commercial and Government insurance companies as well as benefits, deductibles, OOP’s, coinsurance, copay, pre-authorization requirements, and claim processing with payments and denials.
• Initiates electronic and/or telephone inquiries to the appropriate party (ies) including third party payers, employers, and/or claims administrators sharing information, as necessary, in order to secure, record and electronically enter data which confirms the patient’s eligibility for third party benefits and the detailed level of benefits for the services being provided, as well as any other essential claim submission instructions that might be identified during this inquiry.
• Secures and witnesses all required signatures according to internal policy and regulation as applicable including Release of Information, Financial Assistance Application, Financial Agreement and other attestations as applicable; appropriately documents all activities to account to ensure that account history is maintained.
• Accurately scans all face sheets, insurance cards,  and all other necessary registration/admission documents so that they can be permanently stored on optical disk.
• Entering new patient information into various systems and attaching correct documents.
• Provides information and explanations to the patient or responsible party regarding the policy and various options for resolving the calculated self-pay liability for the service being provided.
• Accurately prepares,…